Numerous barriers threaten access to oral health services for young children. Enacted policies regarding the coverage of oral health services do not necessarily translate into realized access for children. Low levels of provider participation and reimbursement rates in publicly funded programs are key factors in this unrealized access to oral health services. In addition, children enrolled in these public programs are from lower socioeconomic families and tend to face multiple barriers to accessing health care. North Carolina's SCHIP program, or Health Choice (NCHC) program, provides health services, including dental through NC Blue Cross/ Blue Shield's private insurance program. The other public health insurance program is the state Medicaid program. This investigation represents an in-depth comparison of children's dental health status and their receipt of dental services through the NC Medicaid Program versus the NC Health Choice Program. This analysis will link children, ages 1-5, enrolled in Medicaid or NCHC to their dental claims file from July 1999 through June 2000, creating person-level data on the utilization of dental services. In addition the NC surveillance of dental caries in Kindergarten aged children for the 1999-2000 school year will be merged with procedure claims creating person-level data on clinical status and use of dental services for a representative sample of young children who were defined by Medicaid and NCHC enrollment. The first part of the investigation compares the use of dental services between Medicaid and NCHC for children 1 to 5 years of age. The second part of the investigation examines differences in specified process measures of plan performance between the two insurance programs. The third part of the investigation compares the dental health status and untreated dental disease of kindergarten aged children enrolled in either public dental program. This project represents an in-depth comparison of the utilization of dental services, effectiveness of established pediatric oral health performance measures, and dental services, effectiveness of established pediatric oral health performance measures, and dental health status for children enrolled in either the NC Medicaid program or NCHC. This study provides an opportunity to determine the benefits of public dental insurance for low income children when structured similar to private insurance.